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Haack C, Zeppieri G, Moser MW. Rehabilitation Following ACL Repair with Internal Brace Ligament Augmentation in Female Gymnast: A Resident's Case Report. Int J Sports Phys Ther 2024; 19:745-757. [PMID: 38835983 PMCID: PMC11144659 DOI: 10.26603/001c.117773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/09/2024] [Indexed: 06/06/2024] Open
Abstract
Introduction Anterior Cruciate Ligament (ACL) injuries continue to be a major source of morbidity in gymnastics. The gold standard is to perform an ACL Reconstruction (ACLR). However, injuries to the proximal femoral attachment of the ACL have demonstrated an ability to regenerate. An alternative surgical intervention to the ACLR in this ACL tear subgroup is an ACL repair. The purpose of this case report is to provide a rehabilitation progression for a female gymnast after an ACL repair with Internal Brace Ligament Augmentation (IBLA). Case Description The subject was a 16-year-old female who presented with a Sherman Type 1 proximal avulsion of her ACL. She underwent an ACL repair with IBLA. Physical therapy interventions followed a sequential and multi-phased approach based on time for tissue physiologic healing and individual progression. Patient reported outcomes including the International Knee Documentation Committee (IKDC), the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) and the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) were assessed in conjunction with isokinetic strength and hop performance testing to determine return to sport readiness. Outcomes The subject completed 42 sessions over the course of 26 weeks in addition to a home exercise program. At return to sport, clinically meaningful improvement was observed in patient reported outcomes including the IKDC, ACL-RSI, and OSPRO-YF. Additionally, strength and hop performance surpassed established thresholds of clinical significance. The subject returned to sport at six months post-operatively. Conclusion The subject in this case report returned to full participation in gymnastics six months after an ACL repair with internal bracing following a sequential and multi-phased rehabilitation. The primary ACL repair with IBLA appeared beneficial to this patient and could benefit from additional study in other athletes and athletic populations. Level of Evidence Level 5.
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Affiliation(s)
- Colten Haack
- Department of Sports MedicineUniversity of Wisconsin Health
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Gavaskar AS, Tummala NC, Reddy CR, Gopalan H, Srinivasan P. What Is the Likelihood of Union and Frequency of Complications After Parallel Plating and Supplemental Bone Grafting for Resistant Distal Femoral Nonunions? Clin Orthop Relat Res 2024; 482:362-372. [PMID: 37638842 PMCID: PMC10776157 DOI: 10.1097/corr.0000000000002809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/11/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Management of resistant distal femur nonunions is challenging because patients not only have disability from an unhealed fracture, but also often have a shortened femur, stiff knee, deformities, and bone defects to address during revision surgery. Dual plating of the distal femur in such a setting can maintain stability that allows the nonunion to heal while also addressing bone defects and correcting deformities simultaneously. Dual-plating techniques that have been described lack standardization with regard to the size and type of medial-side implants and configuration of the dual-plate construct. QUESTIONS/PURPOSES (1) What proportion of patients achieve radiologic evidence of union after parallel plating of resistant distal femoral nonunions? (2) What improvements in function are achieved with this approach, as assessed by improvements in femoral length discrepancy, knee flexion, and patient-reported outcome scores? (3) What complications are associated with the technique? METHODS Between 2017 and 2020, the senior author of this study treated 38 patients with resistant distal femoral nonunions, defined here as nonunions that persisted for more than 12 months since the injury despite a minimum of two previous internal fixation procedures. During the study period, our preferred technique for treating aseptic, resistant distal femoral nonunions was to use dual plates in a parallel configuration augmented with autografts. Of 38 patients, three patients with active signs of infection who underwent resection and reconstruction using bone transport techniques and two patients older than 65 years with deficient distal femur bone stock who underwent endoprosthetic reconstruction were excluded. Of the 33 included patients, 67% (22 of 33) were male. The median age was 40 years (range 20 to 67 years). Nonunion was articular and metaphyseal in 13 patients and metaphyseal only in 20 patients. Our surgical approach was to remove existing implants, perform intraoperative culturing to rule out infection, debride the nonunion, correct the deformity, perform intra-articular and extra-articular lysis of adhesions with quadriceps release, and apply fixation using medial and lateral fixed-angle anatomic locked implants positioned in a parallel configuration. Every attempt to improve length was undertaken, and the defects were filled with autografts. A total of 97% of patients were followed until union occurred (one of 33 was lost to follow-up before union was documented), and 79% (26 of 33) were assessed for functional outcomes at a minimum of 2 years (median 38 months [range 25 to 60 months]) after excluding patients lost to follow-up and those in whom union did not occur after parallel plating. Union was defined as evidence of central trabecular bridging on AP radiographs and posterior cortical bridging on lateral radiographs. These radiologic criteria were defined to overcome difficulties in assessing radiologic healing in patients with lateral and medial plates. With parallel plating, bridging trabecular bone along the posterior cortex on lateral radiographs and the central region on AP radiographs is visualized and can be appreciated and interpreted as evidence of healing in two orthogonal planes. Preoperative and follow-up clinical assessment of knee ROM, the extent of femoral length correction based on calibrated femoral radiographs before and after surgery, and the evaluation of improvement in lower limb function based on the preoperative and follow-up differences in responses to the lower extremity functional scale (LEFS) were studied (the LEFS is scored from 0 to 80, with higher scores representing better function). Complications and secondary surgical procedures to address them were abstracted from a longitudinally maintained trauma database. RESULTS Sixty-seven percent (22 of 33) of nonunions showed radiologic healing by 24 weeks, and another 24% (eight of 33) healed by 36 weeks. Six percent (two of 33) did not unite, and one patient was lost to follow-up before union was documented. In the 79% (26 of 33) of patients available for final functional outcome assessment, the median femoral shortening had improved from 2.4 cm (range 0 to 4 cm) to 1.1 cm (range 0 to 2.3 cm; p < 0.001), and the median knee ROM had improved from 70° (range 20° to 110°) to 100° (range 50° to 130°; p = 0.002) after surgery. The median LEFS score improved to 63 (range 41 to 78) compared with 22 (range 15 to 33; p < 0.001) before surgery. Serious complications, including major thromboembolic events, iliac graft site infection, knee stiffness (flexion < 60°), and medial plate impingement necessitating removal, were seen in 30% (10 of 33) of patients. Secondary surgical interventions were performed in 24% (eight of 33) of patients to address procedure-related complications. CONCLUSION Based on our findings, a high likelihood of union and improvements in knee and lower limb function can be expected with parallel plating of resistant distal femur nonunions using anatomic locked plates. However, the increased frequency of complications observed in our study suggests the need for improvements in dual-plating techniques and to explore possible alternative fixation methods through larger multicenter comparative studies. LEVEL OF EVIDENCE Level IV, therapeutic study.
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Mahmoudi F, Rahnama N, Daneshjoo A, Behm DG. Comparison of dynamic and static balance among professional male soccer players by position. J Bodyw Mov Ther 2023; 36:307-312. [PMID: 37949577 DOI: 10.1016/j.jbmt.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE Balance is an important performance aspect of all athletes. The aim of this study was to compare static and dynamic balance in soccer players in different positions. METHODS Forty youth and young adult professional soccer players were divided into four groups according to their playing positions: goalkeepers (GK), defenders (DF), midfielders (MF) and forwards (FW) (10 per position). Static and dynamic balance assessed on the dominant and non-dominant legs were measured using a force platform for 30s (static one-leg stand), and "Y Balance Test" (dynamic balance). RESULTS GK exhibited greater ML static balance (less ML sway) compared with other players (p < 0.02-0.001). Moreover, results demonstrated better GK dynamic balance compared to DF and FW (p < 0.04-0.006). MF showed better dynamic balance than DF and FW (p < 0.019-0.007) and lower dynamic balance scores were found among DF and FW (p < 0.05). CONCLUSION In conclusion, these results affirm position-specific balance performance with greater static and dynamic balance of GK and dynamic balance with MF. It is suggested that evaluation of balance and postural control performance should be considered a relevant part of the position-specific functional evaluation of soccer players.
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Affiliation(s)
- Foad Mahmoudi
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University of Kerman, Kerman, Iran.
| | - Nader Rahnama
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, University of Isfahan, Isfahan, Iran.
| | - Abdolhamid Daneshjoo
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University of Kerman, Kerman, Iran.
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Canada.
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Algarni FS, Alkhaldi HA, Zafar H, Alhammad SA, Al-Shenqiti AM, Altowaijri AM. Level of disability and associated factors with musculoskeletal disorders among supermarket cashiers. Int J Occup Med Environ Health 2022; 35:407-423. [PMID: 35289336 PMCID: PMC10464787 DOI: 10.13075/ijomeh.1896.01871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 12/22/2021] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES This study aimed to determine the severity of symptoms and the level of disability or difficulty associated with MSDs in the neck, shoulders, upper limbs, lower back, and lower limbs as well as the factors associated with MSDs. MATERIAL AND METHODS This investigation collected demographic, health (36-Item Short Form Survey [SF-36]), and occupational related-factors for supermarket cashiers through the administration of several questionnaires, including the Oswestry Disability Index (ODI), Disabilities of the Arm, Shoulder and Hand (DASH), Neck Disability Index (NDI), Lower Extremity Functional Scale (LEFS), and Numeric Rating Scale (NRS) for pain. RESULTS One hundred ninety-three supermarket cashiers participated in this study. The mean scores for disability levels included NDI (M±SD 18.62±14.57), ODI (M±SD 20.74±13.89), DASH (M±SD 15.08±13.90), and LEFS (M±SD 63.06±14.24). Regression analyses demonstrated the existence of significant relationships between the experience of MSDs and several other factors, including the number of working days per week, the preferred working position, marital status and the need for awkward positions. CONCLUSIONS The results indicate MSDs that signified a mild disability level among young participants. The number of working days per week, the preferred working position, the need to assume awkward positions, and marital status were significantly associated with MSDs. The findings indicated the need for preventive to avoid or minimize the prevalence of MSDs among supermarket cashiers. Int J Occup Med Environ Health. 2022;35(4):407-23.
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Affiliation(s)
- Fahad Saad Algarni
- King Saud University, College of Applied Medical Sciences, Department of Rehabilitation Sciences, Riyadh, Saudi Arabia
| | - Hatem Askar Alkhaldi
- King Saud University, Medical Rehabilitation Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Hamayun Zafar
- King Saud University, College of Applied Medical Sciences, Department of Rehabilitation Sciences, Riyadh, Saudi Arabia
| | - Saad A. Alhammad
- King Saud University, College of Applied Medical Sciences, Department of Rehabilitation Sciences, Riyadh, Saudi Arabia
| | - Abdullah M. Al-Shenqiti
- Taibah University, Al-Madinah Al-Munawarah, Faculty of Medical Rehabilitation Sciences, Saudi Arabia
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Lowe L, Castillo F, Gokun Y, Williams DK, Israel M, Yates C. Static and Dynamic Balance Assessment in Healthy and Concussed Adolescent Athletes. Clin J Sport Med 2022; 32:385-390. [PMID: 34596064 PMCID: PMC8958180 DOI: 10.1097/jsm.0000000000000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 07/26/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to explore the utilization of the Y Balance Test (YBT) alongside the Balance Error Scoring System (BESS) during examination of healthy adolescent athletes (14-18 year old) as well as those with acute and chronic concussion. DESIGN A repeated-measures study of balance in a cross-sectional convenience sample of adolescents participating in high-school athletics. SETTING Data were collected on healthy athletes in their school setting for comparison purposes and on concussed athletes in the physical therapy rehabilitation center at the hospital. PARTICIPANTS Participants were a convenience sample of male and female athletes between the ages of 14 to 18 year old [180 healthy (111 male, 69 female) and 44 (28 male, 16 female) with concussion]. ASSESSMENT OF RISK FACTORS All participants were cleared for participation by preparticipation examination or by the treating sport medicine physician. MAIN OUTCOME MEASURES Healthy athletes performed the YBT, a dynamic assessment of balance. Athletes with concussion also performed the BESS, a static assessment of balance. RESULTS Means for each YBT reach direction were statistically different for both healthy males and females ( P < 0.05). Within both the acute and chronic subsets of the concussed sample, some participants performed over the median value for the BESS but not the YBT. CONCLUSIONS These data may suggest that dynamic balance testing in conjunction with static balance testing could be valuable in both the acute and chronic phases of concussion to ensure a comprehensive assessment of the necessary balance skills for athletic play.
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Affiliation(s)
- Leah Lowe
- Department of Physical Therapy, University of Central Arkansas, USA
| | | | - Yevgeniya Gokun
- Center for Translational Neuroscience, University of Arkansas for Medical Sciences, USA
| | - David K Williams
- Center for Translational Neuroscience, University of Arkansas for Medical Sciences, USA
| | - Michael Israel
- Sports Medicine Clinic, Arkansas Children’s Hospital, USA
| | - Charlotte Yates
- Department of Physical Therapy, University of Central Arkansas, USA
- Center for Translational Neuroscience, University of Arkansas for Medical Sciences, USA
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Acute Impact of Proprioceptive Exercise on Proprioception and Balance in Athletes. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This study aimed to compare the acute effect of a proprioceptive exercise session and a non-specific exercise session on knee position sense, and the static and dynamic balance of athletes. Sixty male athletes (19.4 ± 1.2 years) participated in a within-subjects repeated-measures study. Knee position sense in closed kinetic chain, and static (BESS test) and dynamic balance (Y-balance test) were measured before and after two exercise sessions, consisting of 10 min of non-specific exercise in a cycle-ergometer or proprioceptive exercise with an unstable platform. Overall, both exercise sessions significantly improved knee position sense, BESS score, and YBT composite score, and no differences were detected between proprioceptive and non-specific sessions (knee position sense, −6.9 ± 65.2% vs. −11.5 ± 75.0%, p = 0.680; BESS, −19.3 ± 47.7% vs. −29.03 ± 23.5%, p = 0.121; YBT, 2.6 ± 2.7% vs. 2.2 ± 2.2%, p = 0.305). Twenty athletes did not improve knee position sense after the exercise session (non-responders). When analyzing only the exercise responders, both sessions improved knee position sense, but the improvement was greater after the proprioceptive exercise session (56.4 ± 25.6% vs. 43.8 ± 18.9%, p = 0.023). In conclusion, a single proprioceptive, as well as non-specific, exercise session increased knee position sense and balance. The proprioceptive exercise seems to be more effective in improving joint position sense when considering only athletes who respond to the intervention.
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Abdolahi FH, Variani AS, Varmazyar S. Predicting Ability of Dynamic Balance in Construction Workers Based on Demographic Information and Anthropometric Dimensions. Saf Health Work 2021; 12:511-516. [PMID: 34900370 PMCID: PMC8640614 DOI: 10.1016/j.shaw.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 11/24/2022] Open
Abstract
Background Difficulties in walking and balance are risk factors for falling. This study aimed to predict dynamic balance based on demographic information and anthropometric dimensions in construction workers. Methods This descriptive-analytical study was conducted on 114 construction workers in 2020. First, the construction workers were asked to complete the demographic questionnaire determined in order to be included in the study. Then anthropometric dimensions were measured. The dynamic balance of participants was also assessed using the Y Balance test kit. Dynamic balance prediction was performed based on demographic information and anthropometric dimensions using multiple linear regression with SPSS software version 25. Results The highest average normalized reach distances of YBT were in the anterior direction and were 92.23 ± 12.43% and 92.28 ± 9.26% for right and left foot, respectively. Both maximal and average normalized composite reach in the YBT in each leg were negatively correlated with leg length and navicular drop and positively correlated with the ratio of sitting height to leg length. In addition, multiple linear regressions showed that age, navicular drop, leg length, and foot surface could predict 23% of the variance in YBT average normalized composite reach of the right leg, and age, navicular drop, and leg length could predict 21% of that in the left leg among construction workers. Conclusion Approximately one-fifth of the variability in the normalized composite reach of dynamic balance reach among construction workers using method YBT can be predicted by variables age, navicular drop, leg length, and foot surface.
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Affiliation(s)
- Fateme H Abdolahi
- MSc of Occupational Health Engineering, Faculty of Health, Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Ali S Variani
- Department of Occupational Health Engineering, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Sakineh Varmazyar
- Department of Occupational Health Engineering, Social Determinants Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, Iran
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Lee DW, Lee JK, Cho YC, Yang SJ, Cho SI, Kim JG. Internal Fixation of Lateral Trochlear Groove Osteochondritis Dissecans With Simultaneous Lateral Retinacular Lengthening in Adolescent Athletes. Am J Sports Med 2021; 49:3867-3875. [PMID: 34757816 DOI: 10.1177/03635465211047851] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The goals of operative treatment for the adolescent athlete with unstable osteochondritis dissecans (OCD) lesion are rigid fixation and prevention of recurrence. PURPOSE To evaluate clinical and radiological outcomes of internal fixation of lateral trochlear groove OCD with simultaneous lateral retinacular lengthening. STUDY DESIGN Case series; Level of evidence, 4. METHODS Adolescent athletes who had undergone internal fixation and simultaneous lateral retinacular lengthening for an unstable OCD lesion of the lateral trochlear groove were retrospectively reviewed. Subjective assessments included the Lysholm score, International Knee Documentation Committee (IKDC) subjective score, Tegner activity scale, and an athletic questionnaire. Functional tests included isokinetic muscle strength, single-leg hop for distance, single-leg vertical jump, and Y-balance. Pre- and postoperative radiographs and magnetic resonance images were reviewed. RESULTS The mean ± SD age of the 17 patients included in this study was 15.9 ± 0.9 years; last clinical follow-up duration was 37.7 ± 8.1 months. At the last follow-up, the Lysholm score improved from 68.7 ± 15.3 to 93.4 ± 12.4 and the IKDC subjective score from 60.2 ± 14.7 to 88.7 ± 12.7 (P < .001). The mean Tegner activity scale score was 9.4 ± 0.5 before injury and 8.9 ± 1.2 at the last follow-up (P = .059). The limb symmetry indices of isokinetic muscle strength, single-leg hop for distance, single-leg vertical jump, and Y-balance improved at the last follow-up; the mean limb symmetry index was ≥85% in each functional test. Regarding the athletic questionnaire, 16 (94.1%) patients were satisfied with the surgery. At the last follow-up, 2 patients had higher ability after returning to sports, 11 had the same ability, and 3 had lower ability than the preinjury level. Postoperative magnetic resonance imaging at 12-month follow-up showed that the OCD lesion appeared healed in 7 (41.2%) patients and partially healed in 9 (52.9%). CONCLUSION Internal fixation of lateral trochlear groove OCD with simultaneous lateral retinacular lengthening in adolescent athletes achieved satisfactory clinical and radiological outcomes. Therefore, this combined surgical technique could be considered an effective treatment for lateral trochlear groove OCD, with a high rate of return to sport.
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Affiliation(s)
- Dhong Won Lee
- Department of Orthopaedic Surgery, KonKuk University Medical Center, School of Medicine, Konkuk University, Seoul, Korea
| | - Joon Kyu Lee
- Department of Orthopaedic Surgery, KonKuk University Medical Center, School of Medicine, Konkuk University, Seoul, Korea
| | - Young Chang Cho
- Department of Orthopaedic Surgery, KonKuk University Medical Center, School of Medicine, Konkuk University, Seoul, Korea
| | - Sang Jin Yang
- Department of Health and Exercise Management, TongWon University, Gwangju, Korea
| | - Seung Ik Cho
- Sports Medical Center, KonKuk University Medical Center, Seoul, Korea
| | - Jin Goo Kim
- Department of Orthopedic Surgery, Myongji Hospital, Goyang-si, Korea
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Plisky P, Schwartkopf-Phifer K, Huebner B, Garner MB, Bullock G. Systematic Review and Meta-Analysis of the Y-Balance Test Lower Quarter: Reliability, Discriminant Validity, and Predictive Validity. Int J Sports Phys Ther 2021; 16:1190-1209. [PMID: 34631241 PMCID: PMC8486397 DOI: 10.26603/001c.27634] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/15/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Deficits in dynamic neuromuscular control have been associated with post-injury sequelae and increased injury risk. The Y-Balance Test Lower Quarter (YBT-LQ) has emerged as a tool to identify these deficits. PURPOSE To review the reliability of the YBT-LQ, determine if performance on the YBT-LQ varies among populations (i.e., sex, sport/activity, and competition level), and to determine the injury risk identification validity of the YBT-LQ based on asymmetry, individual reach direction performance, or composite score. STUDY DESIGN Systematic Review. METHODS A comprehensive search was performed of 10 online databases from inception to October 30, 2019. Only studies that tested dynamic single leg balance using the YBT-LQ were included. Studies were excluded if the Y-Balance Test kit was not utilized during testing or if there was a major deviation from the Y-Balance test procedure. For methodological quality assessment, the modified Downs and Black scale and the Newcastle-Ottawa Scale were used. RESULTS Fifty-seven studies (four in multiple categories) were included with nine studies assessing reliability, 36 assessing population differences, and 16 assessing injury prediction were included. Intra-rater reliability ranged from 0.85-0.91. Sex differences were observed in the posteromedial direction (males: 109.6 [95%CI 107.4-111.8]; females: 102.3 [95%CI 97.2-107.4; p = 0.01]) and posterolateral direction (males: 107.0 [95%CI 105.0-109.1]; females: 102.0 [95%CI 97.8-106.2]). However, no difference was observed between sexes in the anterior reach direction (males: 71.9 [95%CI 69.5-74.5]; females: 70.8 [95%CI 65.7-75.9]; p=0.708). Differences in composite score were noted between soccer (97.6; 95%CI 95.9-99.3) and basketball (92.8; 95%CI 90.4-95.3; p <0.01), and baseball (97.4; 95%CI 94.6-100.2) and basketball (92.8; 95%CI 90.4-95.3; p=0.02). Given the heterogeneity of injury prediction studies, a meta-analysis of these data was not possible. Three of the 13 studies reported a relationship between anterior reach asymmetry reach and injury risk, three of 10 studies for posteromedial and posterolateral reach asymmetry, and one of 13 studies reported relationship with composite reach asymmetry. CONCLUSIONS There was moderate to high quality evidence demonstrating that the YBT-LQ is a reliable dynamic neuromuscular control test. Significant differences in sex and sport were observed. If general cut points (i.e., not population specific) are used, the YBT-LQ may not be predictive of injury. Clinical population specific requirements (e.g., age, sex, sport/activity) should be considered when interpreting YBT-LQ performance, particularly when used to identify risk factors for injury. LEVEL OF EVIDENCE 1b.
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Affiliation(s)
| | | | | | | | - Garrett Bullock
- Department of Orthopaedic Surgery, Wake Forest School of Medicine; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Oxford
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Irfan A, Kerr S, Hopper G, Wilson W, Wilson L, Mackay G. A Criterion Based Rehabilitation Protocol for ACL Repair with Internal Brace Augmentation. Int J Sports Phys Ther 2021; 16:870-878. [PMID: 34123539 PMCID: PMC8169034 DOI: 10.26603/001c.22217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 11/26/2020] [Indexed: 12/12/2022] Open
Abstract
The anterior cruciate ligament (ACL) is one of the main stabilizing structures of the knee and its rupture is a common injury in young active adults. ACL reconstruction has been the preferred operative management of an ACL rupture for several decades; however, success rates are variable. Recently, interest in arthroscopic primary repair of the ligament has increased. The repair is augmented with an Internal Brace (IB), which is an ultra-high strength suture tape that bridges the ligament. This technique protects the ligament during the healing and the ligament is encouraged to heal naturally, whilst not requiring any external braces. It acts as a stabiliser to permit early mobilization and optimise rehabilitation. As understanding of rehabilitation has progressed, there has been an increased focus on early weight-bearing and achieving full range of movement. While detailed criterion-based rehabilitation protocols exist for ACL reconstruction, this is not the case for ACL repair. The purpose of this commentary is to present a novel criterion-based rehabilitation protocol following ACL repair surgery augmented with an IB. LEVEL OF EVIDENCE V.
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Arhos EK, Lang CE, Steger-May K, Van Dillen LR, Yemm B, Salsich GB. Task-specific movement training improves kinematics and pain during the Y-balance test and hip muscle strength in females with patellofemoral pain. J ISAKOS 2021; 6:277-282. [PMID: 34001505 DOI: 10.1136/jisakos-2020-000551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Task-specific movement training is a proposed intervention for patellofemoral pain aimed to optimise movement during daily tasks. Focused, progressive task practice emphasising optimal limb alignment may yield improvements in performance-based function and hip muscle strength, and transfer learnt movement patterns to untrained tasks. The purpose of this study was to determine if task-specific movement training improves performance-based function (composite score, movement, pain during movement) in an untrained task. Our secondary purpose was to test whether hip muscle strength improved following the movement training intervention. METHODS This study was a secondary analysis of a prospective, non-randomised, within-group, double-baseline study. Twenty-three females with patellofemoral pain underwent task-specific movement training two times/week for 6 weeks. Outcomes were collected at three time points: enrolment (baseline), 6 weeks (preintervention) and 12 weeks (postintervention). A repeated measures analysis of variance tested whether the change during the intervention phase was greater than the change during the control phase. Y-balance composite score, hip and knee kinematics and pain during the Y-balance test were primary outcome measures; strength of the hip lateral rotator, abductor and extensor muscles was a secondary outcome measure. RESULTS The change in composite score for the Y-balance test was not statistically significantly different between the intervention and control phases (p=0.16). The change during the intervention phase exceeded the change during the control phase for hip and knee kinematics and pain during the Y-balance test, with all variables improving (p<0.0001). The change during the intervention phase was greater than the control phase for hip muscle strength, with all variables improving (p<0.04). CONCLUSION Although the Y-balance test composite score did not improve, performance-based function during an untrained task, measured by movement and pain during the test, improved following task-specific movement training. Hip muscle strength improved, despite no focused muscle strengthening. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Elanna K Arhos
- Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Catherine E Lang
- Program in Physical Therapy, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Karen Steger-May
- Division of Biostatistics, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Linda R Van Dillen
- Program in Physical Therapy, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Barbara Yemm
- Program in Physical Therapy, Saint Louis University, St Louis, Missouri, USA
| | - Gretchen B Salsich
- Program in Physical Therapy, Saint Louis University, St Louis, Missouri, USA
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The role of the dominant leg while assessing balance performance. A systematic review and meta-analysis. Gait Posture 2021; 84:66-78. [PMID: 33278778 DOI: 10.1016/j.gaitpost.2020.11.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 10/26/2020] [Accepted: 11/08/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Good balance is a pre-requisite for various activities of daily life and sports. Physiotherapists thus regularly assess and train patient's balance capacities. In order to interpret the test results of unilateral balance tests, a comparison with normative data is common. In patients who had an injury or a surgery, the performance of the injured leg is often compared with performance of the non-injured leg. Nevertheless, it remains unclear if unilateral balance performance differs between the dominant and non- dominant legs. If so, this should take into consideration when interpreting test results. RESEARCH QUESTION This meta-analysis summarized the current evidence to determine if the balance performance of healthy adults was influenced by the leg's dominance. METHODS Articles were searched in PubMed, CINAHL, Cochrane and Embase. Data from studies meeting the pre-defined inclusion criteria were extracted in a standardized form. A meta-analysis was conducted using a random effect model. RESULTS Forty-six studies were included. Their data were allocated in 7 categories of balance tests. Significant differences between the dominant and the non-dominant legs were not found in any of the categories (surface stable, eyes open: -0.04, 95 % CI -0.12 to 0.05, surface stable eyes closed: -0.06, 95 % CI -0.22 to 0.11, surface unstable, eyes open: -0.15, 95 % CI -0.38 to 0.07, surface unstable, eyes closed: -0.06, 95 % CI -0.27 to 0.15, BESS (Balance Error Scoring System): 0.03, 95 % CI -1.09 to 1.14, SEBT (Star Excursion Balance Test)/YBT (Y Balance Test): 0.06, 95 % CI -0.04 to 0.16, jump: 0.04, 95 % CI -0.28 to 0.36). SIGNIFICANCE Results indicate that balance performance is not influenced by the leg's dominance. This means that performances of both legs can be used as reference. Evidence is strong for the one leg stance. However, future studies are needed to confirm our results for stabilization tasks after a jump landing.
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Determinants of regeneration and strength of hamstrings after anterior cruciate ligament reconstruction-fate of hamstring tendon. INTERNATIONAL ORTHOPAEDICS 2021; 45:1751-1760. [PMID: 33409561 DOI: 10.1007/s00264-020-04932-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/29/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM Arthroscopic reconstruction of anterior cruciate ligament (ACL) surgical procedure using hamstring autograft is the most common surgery performed in the arena of sports medicine and arthroscopy. Most studies in literature are ambiguous regarding the fate of hamstrings based on function, regenerative potential, and cross-sectional area (CSA). The aim of this research study is analysis of the fate of hamstring tendons (both semitendinosus and gracilis) during the time course for determinants of regeneration and strength. METHODS Fifty patients who were operated for unilateral isolated ACL reconstruction from July 2015 to June 2018 were evaluated for the fate of harvested hamstring tendons which included the following: regeneration, cross-sectional area (CSA), strength, and insertion of regenerated hamstrings by isometric torque and isokinetic strength. MRI of knee was performed for both knees concerning the semitendinosus (ST), gracilis (G), Sartorius, biceps femoris, and medial head of gastrocnemius. RESULTS Eighty-four percent men and 16% women within a mean patient age of 34 ± 4.12 years were evaluated and all 50 (100%) patients demonstrated hamstring regeneration by the MRI measurements at six months and at one year post-ACL reconstruction. The torque of isometric knee flexion measured in 60° was found to be remarkably lower in the ACL-reconstructed lower extremity compared to that of the contralateral limb (87.13 ± 20.18% of BW), at 90° (49.17 ± 15.09% BW), and at 105° (43.91 ± 13.17% BW), respectively (p < 0.01). However, at 30° flexion and 45° flexion, the difference was insignificant (116.48 ± 21.07% BW for 30° and 100.16 ± 25.12% BW for 45°). CONCLUSIONS It was found that the properties of musculotendinous units of ST and G were significantly transformed after their harvesting for ACL reconstruction and these weaknesses contribute to the flexion deficit of knee in the deeper range of flexion in the operated limb. Therefore, approaches facilitating tendon regeneration and preservation must be warranted.
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Assessment of the Relationship between Y-Balance Test and Stabilometric Parameters in Youth Footballers. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6968473. [PMID: 33274220 PMCID: PMC7683114 DOI: 10.1155/2020/6968473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 11/28/2022]
Abstract
Objectives The purpose of the study was to evaluate the correlation between dynamic test results obtained on a stabilometric platform and the results achieved on the Y-balance test (Y-BT). Method The study group consisted of 52 adolescent athletes, aged 14 to 17 years. Each participant was evaluated in the scope of their ability to maintain dynamic balance using the Y-BT as well as via dynamic tests on the ‘Alfa' stabilometric platform. The following parameters were analysed: (a) from the Y-BT—relative reach of the right and left lower limbs in the anterior, posterolateral, and posteromedial directions, as well as the side-to side difference in relative reach for each direction and (b) from the ‘Alfa' platform—path length and time to reach the target using right and left lower limbs in the anterior and posterior directions. Results A correlation between the results obtained on the stabilometric platform and the Y-BT was found only for the posteromedial direction. Statistical analysis demonstrated that the increased difference between the right and left lower limbs in the posteromedial test is related to an increase in time taken to reach the points located forward and to the left, and backwards and to the right, as well as an increase in the overall time required to complete the task on the stabilometric platform. Conclusions The results from the Y-BT and stabilometric platform are weakly related in adolescents. These findings indicate that the Y-BT and stabilometric platform analyse different kinds of dynamic balance in adolescents. Thus, these tools should not be used interchangeably in clinical practice or scientific research.
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Shamsi M, Mirzaei M, Shahsavari S, Safari A, Saeb M. Modeling the effect of static stretching and strengthening exercise in lengthened position on balance in low back pain subject with shortened hamstring: a randomized controlled clinical trial. BMC Musculoskelet Disord 2020; 21:809. [PMID: 33276764 PMCID: PMC7718700 DOI: 10.1186/s12891-020-03823-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 11/23/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Hamstring shortening may have negative impacts on function and biomechanics of knee and hip joints and lumbo-pelvic rhythm. Many interventions are believed to correct hamstring to its normal length. There are several reports of impairment in postural control of patients with low back pain. The purpose of this study was to compare the effect of stretching exercise and strengthening exercise in lengthened position of the hamstring muscle on improving the dynamic balance of the person in patients with chronic low back pain with short hamstring muscles. METHODS Forty-five patients with hamstring shortening who referred to physiotherapy clinic of Kermanshah university of Medical Sciences, Kermanshah, Iran were randomly allocated to the three groups; static stretching (n = 15), strengthening exercise in lengthened hamstring position (n = 15) and control (n = 15). All groups received conventional physiotherapy for low back pain and the two intervention groups received stretching exercise and strengthening exercise in lengthened position programs as well. All groups performed three treatment sessions for a week, a total of 12 sessions. For balance assessment, Y-Balance test was performed for each participant in three reach directions. To determine the important and significant variables, all variables entered a model (Generalized Estimation Equations method). RESULTS The results indicate that based on GEE model, by controlling other variables, participants of static stretching exercise showed more improvement in balance than control group (β = 9.58, p-value = 0.014). Also, balance status showed significant improvement in the end of study compared to baseline of the study (β = 7.71, P-value< 0.001). In addition, the balance in three reach directions improved significantly and the greatest balance improvement was in the anterior reach direction (β ranged over = 6.16 to 11.59) and the height of patients affected their balance (β = 0.28, P-value = 0.034). CONCLUSIONS Group (type of intervention), phase of intervention, reach direction of test (anterior, posteromedial and posterolateral) and height of participants were associated with balance performance. Static stretching exercise was more effective than muscle strengthening exercise in lengthened position for improving dynamic balance in low back pain patients with hamstring tightness. TRIAL REGISTRATION Iranian Registry of Clinical Trials (I RCT201507258035n2 ). Registered 16th September 2015.
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Affiliation(s)
- MohammadBagher Shamsi
- School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Mirzaei
- School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Soodeh Shahsavari
- Department of Health Information Management, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ameneh Safari
- Esfarayen Facualty of Medical Sciences, Esfarayen, Iran
| | - Morteza Saeb
- Assistant professor of Orthopedic Surgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Fusco A, Giancotti GF, Fuchs PX, Wagner H, Varalda C, Capranica L, Cortis C. Dynamic Balance Evaluation: Reliability and Validity of a Computerized Wobble Board. J Strength Cond Res 2020; 34:1709-1715. [PMID: 29481451 DOI: 10.1519/jsc.0000000000002518] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Fusco, A, Giancotti, GF, Fuchs, PX, Wagner, H, Varalda, C, Capranica, L, and Cortis, C. Dynamic balance evaluation: reliability and validity of a computerized wobble board. J Strength Cond Res 34(6): 1709-1715, 2020-Computerized wobble boards (WBs) are inexpensive, transportable, and user-friendly devices to objectively quantify the dynamic balance performances out of laboratory settings, although it has not been established if they are reliable and valid tools. Therefore, the purpose of this study was to determine the reliability and validity of a computerized WB. Thirty-nine (18 females and 21 males) young adults (age: 23.3 ± 2.1 years; body mass: 65.9 ± 1.8 kg; height: 168.2 ± 8.8 cm; leg length: 78.8 ± 5.7 cm; and body mass index: 23.2 ± 2.1 kg·m) participated in the study. Subjects were assessed during 3 separate sessions on different days with a 48-hour rest in between. A total number of 2 WB single limb tests and 1 Y Balance Test (YBT) were performed. The WB performance was registered using the proprietary software and represented by the time spent in the target zone, which represented the 0° tilt angle measured by the triaxial accelerometer in the WB. YBT normalized reach distances were recorded for the anterior, posteromedial, and posterolateral directions. Intraclass correlation coefficient, 95% confidence interval, SEM, minimal detectable change, and Bland-Altman plots were used to evaluate intrasession and intersession reliability, whereas Pearson product moment correlation was used to determine concurrent validity. Reliability ranged from fair to excellent, showing acceptable levels of error and low minimal detectable change. However, all correlation coefficients between WB and YBT outcomes were poor. Despite the 2 methods addressing different aspects of balance performance, WB seems to validly serve its purpose and showed good reliability. Therefore, computerized WBs have the potential to become essential devices for dynamic balance assessment.
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Affiliation(s)
- Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy.,Department of Sports Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Giuseppe F Giancotti
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Philip X Fuchs
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy.,Department of Sports Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Herbert Wagner
- Department of Sports Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Carlo Varalda
- Italian Weightlifting Federation FIPE, Rome, Italy; and
| | - Laura Capranica
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
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Motealleh A, Barzegar A, Abbasi L. The immediate effect of lumbopelvic manipulation on knee pain, knee position sense, and balance in patients with patellofemoral pain: A randomized controlled trial. J Bodyw Mov Ther 2020; 24:71-77. [PMID: 32826011 DOI: 10.1016/j.jbmt.2020.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/27/2019] [Accepted: 01/28/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Patellofemoral pain (PFP) is a common musculoskeletal disorder. Quadriceps and core muscle neuromuscular control impairments are frequently associated with PFP. Lumbopelvic manipulation (LPM) has been shown to improve quadriceps and core muscle activation and decrease their inhibition, but changes in balance and knee joint position sense (JPS) after this intervention remain unknown. OBJECTIVE To determine whether LPM decreases knee pain and JPS error and increases balance performance in patients with PFP. DESIGN Randomized controlled trial. SETTING Biomechanics laboratory at a rehabilitation science research center. METHODS Forty-four patients with PFP participated in this study that randomly divided into two equal groups. One group received LPM and the other received sham LPM (positioning with no thrust) in a single session. At baseline and immediately after the intervention, the outcomes of pain using a visual analog scale, balance using the modified star excursion balance test (mSEBT), and JPS at 20° and 60° of knee flexion using a Biodex dynamometer. RESULTS There was a statistically significant improvement in pain, balance control (anterior direction) and JPS in the LPM group immediately after the intervention. In addition, we observed significant differences between groups in pain, balance control (anterior direction) and JPS at 60° of knee flexion immediately after the intervention. CONCLUSION A single session of LPM immediately improved balance control, knee JPS, and pain in patients diagnosed with PFP. CLINICAL REHABILITATION IMPACT Findings suggest that LPM may be used as a therapeutic tool for immediate improvement of symptoms of PFP. However, more research is needed to determine long term results.
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Affiliation(s)
- Alireza Motealleh
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Barzegar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Abbasi
- Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Alghadir AH, Iqbal ZA, Iqbal A, Ahmed H, Ramteke SU. Effect of Chronic Ankle Sprain on Pain, Range of Motion, Proprioception, and Balance among Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5318. [PMID: 32718066 PMCID: PMC7432694 DOI: 10.3390/ijerph17155318] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/26/2022]
Abstract
Background: Ankle sprains are common among physically active individuals, especially among athletes. Majority of those who suffer ankle sprains have residual symptoms including pain, episodes of giving way, compromised proprioception and neuromuscular control, and re-injury leading to chronic ankle instability. The aim of this study was to see the effect of chronic ankle sprain on pain, range of motion, proprioception, and, static and dynamic balance among athletes. Methods: A total of 80 athletes, aged 18 to 25 years, involved in track-and-field sports were invited to participate in this study. They were divided in two groups. Athletes with history of grade 1 or 2 ankle sprain on either side requiring medical care who reported at least three episodes of ankle giving way in past 12 months were included in group A. An equal number of healthy athletes without any history of ankle sprain or injury in the lower limbs in the past one year matched by sex, age, height, weight, and limb dominance, were included in group B (control). Outcome measures: Participant's pain, range of motion, proprioception and balance (static and dynamic) was measured using visual analog scale, half circle goniometer, degree of foot position sense, single leg stance time and Y-balance test respectively. Results: Although there were no differences in the active ankle joint range of motion (p > 0.05) in comparison to the control group, athletes with chronic ankle sprain reported mild pain and statistically significant (p < 0.05) deficits in foot proprioception, static and dynamic balance. Conclusions: Deficits in foot proprioception, static and dynamic balance even one year after the ankle sprain could be the reason for limitations in the dynamic defense system of the joint that predisposes to recurrent injury and instability. It is essential to understand the normal clinical course and risk factors for athletes who sustain sprain before devising a long term comprehensive rehabilitation program that focuses on mechanical and functional insufficiencies in order to improve their functional performance and prevent the risk of recurrent sprain.
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Affiliation(s)
- Ahmad H. Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Zaheen A. Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Amir Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia; (A.H.A.); (A.I.)
| | - Hashim Ahmed
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia;
| | - Swapnil U. Ramteke
- Department of Musculoskeletal & Sports Physiotherapy, Sancheti Institute College of Physiotherapy, Shivaji Nagar, Pune 411005, Maharashtra, India;
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Lower Quarter Y Balance Test performance: Reference values for healthy youth aged 10 to 17 years. Gait Posture 2020; 80:148-154. [PMID: 32505979 DOI: 10.1016/j.gaitpost.2020.05.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/28/2020] [Accepted: 05/26/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Lower Quarter Y Balance Test (YBT-LQ) has been widely used to register dynamic balance performance in children and adolescents. However, studies evaluating age- and sex-specific normative data to assess and classify YBT-LQ performance for these age-cohorts are missing. OBJECTIVE Thus, we investigated YBT-LQ performance in healthy youth to provide age- and sex-specific reference values. METHODS Six-hundred and sixty-nine individuals (286 female, 383 male) aged 10-17 years performed the YBT-LQ with their left and right leg. Normalized maximal reach distances (% leg length) for all three directions (i.e., anterior, posterolateral, posteromedial) and the composite score were calculated. Further, age- and sex-specific percentile values (i.e., 10th to 90th percentile) were computed and plotted. RESULTS In boys, the oldest age group (16-17 years) performed better than the younger ones (14-15, 12-13, and 10-11 years). In girls, the youngest age group (10-11 years) often achieved better values compared to the 12-13-year olds. Further, 16-17-year old boys compared to the same aged girls showed better YBT-LQ performance in all but one measure (except left leg reach in posterolateral direction). For both sexes, curvilinear shaped curves were detected for percentile values across the reach directions. CONCLUSIONS The generated age- and sex-specific reference values for the YBT-LQ can be used by practitioners to evaluate dynamic balance performance in healthy youth aged 10-17 years.
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Y-Balance Test Asymmetry and Frontal Plane Knee Projection Angle During Single-leg squat as Predictors of Patellofemoral Pain in Male Military Recruits. Phys Ther Sport 2020; 44:121-127. [DOI: 10.1016/j.ptsp.2020.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 11/19/2022]
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O'Connor S, McCaffrey N, Whyte EF, Fop M, Murphy B, Moran K. Can the Y balance test identify those at risk of contact or non-contact lower extremity injury in adolescent and collegiate Gaelic games? J Sci Med Sport 2020; 23:943-948. [PMID: 32362482 DOI: 10.1016/j.jsams.2020.04.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 12/12/2019] [Accepted: 04/21/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Lower extremity (LE) injuries are common in Gaelic games and lead to a significant economic and injury burden. Balance is considered a predictor of injury in other sports, however no research has examined its effect on LE injury in Gaelic games. This study aims to present normative data for the Y Balance Test (YBT), determine whether the YBT can identify those at risk of contact and non-contact LE and ankle injuries and generate population specific cut-off points in adolescent and collegiate Gaelic games. DESIGN Prospective cohort study. METHODS A convenience sample of 636 male adolescent (n=293, age=15.7±0.7 years) and collegiate (n=343, age=19.3±1.9 years) Gaelic footballers and hurlers were recruited. The YBT was completed and injuries were assessed at least weekly over one season. Univariate and logistic regression was performed to examine if the YBT can classify those at risk of LE-combined and ankle injuries. ROC curves were used to identify cut-off points. RESULTS Gaelic players performed poorly in the YBT and between 31-57% of all players were identified as at risk of injury at pre-season using previously published YBT cut-off points. However, poor YBT scores were unable to ascertain those at risk of contact or non-contact LE-combined and ankle injuries with sufficient sensitivity. High specificity was noted for contact LE-combined and non-contact ankle injuries. CONCLUSIONS The YBT as a sole screening method to classify those at risk of LE and ankle injuries in Gaelic games is questionable. However, the YBT may be a useful preliminary screening tool to identify those not at risk of contact LE-combined or non-contact ankle injury. Generalising published cut-off points from other sports is not supported.
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Affiliation(s)
- Siobhán O'Connor
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, School of Health and Human Performance, Dublin City University, Ireland.
| | - Noel McCaffrey
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, School of Health and Human Performance, Dublin City University, Ireland
| | - Enda F Whyte
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, School of Health and Human Performance, Dublin City University, Ireland
| | - Michael Fop
- School of Mathematics and Statistics, University College Dublin, Ireland
| | - Brendan Murphy
- School of Mathematics and Statistics, University College Dublin, Ireland
| | - Kieran Moran
- Centre for Injury Prevention and Performance, Athletic Therapy and Training, School of Health and Human Performance, Dublin City University, Ireland; NSIGHT Research Centre, Dublin City University, Ireland
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Ryu CH, Park J, Kang M, Oh JH, Kim YK, Kim YI, Lee HS, Seo SG. Differences in lower quarter Y-balance test with player position and ankle injuries in professional baseball players. J Orthop Surg (Hong Kong) 2020; 27:2309499019832421. [PMID: 30857473 DOI: 10.1177/2309499019832421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Although there has been research about the correlation between ankle injury and Y-balance test (YBT) conducted in other sports, there has been a lack of research on the correlation between ankle injury among baseball players and YBT scores or on differences in scores according to baseball positions. This study focused on professional baseball players as its subjects with the aims of analyzing the correlation between YBT and ankle injury and assessing differences in YBT between baseball positions. METHODS Age, height, weight, body mass index, and spine malleolar distance of 42 professional baseball players were measured. YBT measurements were performed using each foot in three distinct directions. YBT normalized reach distances, composite score, and reach asymmetry were analyzed. RESULTS The mean right posteromedial normalized reach distances for the player positions were significantly different between the pitchers (107.7%) and infielders (113.7%) ( p = 0.028). For the composite score, the difference between the pitchers (92.3%) and infielders (95.0%) was statistically significant ( p = 0.048). The anterior reach asymmetry was larger in the injured group than in the noninjured group ( p = 0.041). CONCLUSION This study shows that YBT can be used as a way of evaluating the injury of baseball players. It also shows the reference value of YBT according to position in professional baseball players. This study could be useful for the treatment of ankle injury of baseball players. Level of evidence: Level 3.
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Affiliation(s)
- Chang Hyun Ryu
- 1 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jungu Park
- 1 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mina Kang
- 1 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joo Han Oh
- 2 Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - You Keun Kim
- 1 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Il Kim
- 3 LG Twins Professional Baseball Club, Seoul, Republic of Korea
| | - Ho Seong Lee
- 1 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Gyo Seo
- 1 Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Y-Balance Test Performance Does Not Determine Non-Contact Lower Quadrant Injury in Collegiate American Football Players. Sports (Basel) 2020; 8:sports8030027. [PMID: 32120772 PMCID: PMC7183065 DOI: 10.3390/sports8030027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 11/16/2022] Open
Abstract
Collegiate American football has a high rate of injury. The Lower Quarter Y-Balance Test (YBT-LQ), a dynamic assessment of lower extremity strength, mobility, and balance, has been purported to identify athletes at risk for injury in different sports including football. Previous studies examining the association between YBT-LQ and injury have reported varied findings; therefore, the purpose of this study was to assess if preseason YBT-LQ performance predicted whether football players would sustain a non-contact lower extremity or low back (lower quarter (LQ)) injury during the season. Fifty-nine male collegiate American football players (age 20.8 ± 1.3 y, height 1.8 ± 0.1 m, body mass 94.6 ± 14.2 kg) completed a survey of training and injury history and had their YBT-LQ performance assessed at the start of the season. Athletic training staff tracked the occurrence of non-contact LQ injuries during the season. There were no significant relationships found between preseason YBT-LQ values and incidence of non-contact LQ injury in this population of collegiate American football players. This study is consistent with recent reports that have not found a significant association between preseason YBT-LQ values and LQ injury. These results suggest that, in isolation, the YBT-LQ may have limited utility as a screening test for non-contact injury in collegiate football players.
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Schilling D, Radwan A. Are athletes ready to return to competitive sports following ACL reconstruction and medical clearance? COGENT MEDICINE 2020. [DOI: 10.1080/2331205x.2020.1723822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Dave Schilling
- Physical Therapy Program, Utica College 1600 Burrstone Road Utica NY 13502 USA
| | - Ahmed Radwan
- Physical Therapy Program, Utica College 1600 Burrstone Road Utica NY 13502 USA
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Zafar H, Alghadir AH, Iqbal ZA, Iqbal A, Anwer S, Alnahdi AH. Influence of different jaw positions on dynamic balance using Y-balance test. Brain Behav 2020; 10:e01507. [PMID: 31859447 PMCID: PMC6955923 DOI: 10.1002/brb3.1507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Jaw sensory-motor system has been shown to affect static balance of the body. It would be interesting to know whether it can influence dynamic balance as well. The objective of this study is to examine the influence of different jaw positions on dynamic balance using the Y-balance test. METHODS Eighty healthy male participants aged 20-35 years were invited to participate in this study. Dynamic balance was measured by the Y-balance test in three directions (anterior, posteromedial, and posterolateral) for each leg separately in three jaw positions: resting jaw (control), open-jaw, and clenched jaw. RESULTS There were no significant differences in reach distances between the different jaw positions except in the posterolateral direction. In comparison with resting jaw position, reach distance was significantly higher in open-jaw position for the right leg and in clenched and open-jaw positions for the left leg in the posterolateral direction. CONCLUSIONS Although various studies have shown direct or indirect influence of jaw sensory-motor system on static postural control, results of this study point to limited relation with dynamic postural control among healthy subjects. However, it supports the potential of the jaw sensory-motor system to affect motor control during functional tasks in patients with postural instability or similar disorders.
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Affiliation(s)
- Hamayun Zafar
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umea University, Umea, Sweden
| | - Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Zaheen Ahmed Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Shahnawaz Anwer
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,Department of Building and Real-Estate, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Ali H Alnahdi
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Alsufiany MB, Lohman EB, Daher NS, Gang GR, Shallan AI, Jaber HM. Non-specific chronic low back pain and physical activity: A comparison of postural control and hip muscle isometric strength: A cross-sectional study. Medicine (Baltimore) 2020; 99:e18544. [PMID: 32000363 PMCID: PMC7004720 DOI: 10.1097/md.0000000000018544] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Most research on sedentary lifestyle has focused on pain and disability, while neuromuscular outcomes (postural control and strength) have received less attention. The objective of the study was to determine whether low level of physical activity is negatively associated with measures of lower body muscular strength and postural control in individuals with and without non-specific chronic low back pain (NSCLBP).Twenty-four subjects with NSCLBP (28.8 ± 5.9 years) and 24 age, gender, and body mass index matched healthy controls participated in the study. Subjects were sub-classified into 4 subgroups based on their physical activity level: Non-active NSCLBP; Active NSCLBP; Non-active healthy control; and Active healthy control. Each subgroup consisted of 12 subjects. Peak force of hip muscles strength was assessed using a handheld dynamometer. Postural control was assessed using computerized posturography and the Y Balance Test.There was no significant group by physical activity interaction for strength and static and dynamic postural control, except for static control during left single leg stance with eyes closed (P = .029). However, there was a significant difference in strength and postural control by physical activity (P < .05). Postural control and peak force of hip muscles strength were significantly associated with physical activity (r ranged from 0.50 to 0.66, P < .001 and r ranged from 0.40 to 0.59, P < .05, respectively).Postural control and hip strength were independently related to physical activity behavior. A sedentary behavior may be an important risk factor for impaired postural control and hip muscles strength, and that physical fitness is vital to neuromuscular outcomes.
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Affiliation(s)
- Muhsen B. Alsufiany
- Department of Physical Therapy
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Taif University, Kingdom of Saudi Arabia
| | | | - Noha S. Daher
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA
| | | | | | - Hatem M. Jaber
- Department of Allied Health Studies, School of Allied Health Professions, Loma Linda University, Loma Linda, CA
- Department of Physical Therapy, College of Rehabilitative Sciences, University of St. Augustine for Health Sciences, Austin, TX
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Bliekendaal S, Stubbe J, Verhagen E. Dynamic balance and ankle injury odds: a prospective study in 196 Dutch physical education teacher education students. BMJ Open 2019; 9:e032155. [PMID: 31892652 PMCID: PMC6955497 DOI: 10.1136/bmjopen-2019-032155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate whether dynamic balance, measured with the anterior component of the Star Excursion Balance Test (SEBT-ANT), is a risk factor for ankle injuries in physical education teacher education (PETE) students. DESIGN AND SETTING A prospective monocentre study in first-year PETE students. PARTICIPANTS A total of 196 subjects, of which 137 men (70%) and 59 women (30%). OUTCOME MEASURES This study consisted of measures of the SEBT-ANT at baseline (September 2015) and an injury registration procedure during a follow-up period (September 2015-June 2016). The association between the SEBT-ANT score and subsequent ankle injury was analysed with generalised estimating equations analysis at the leg level. RESULTS Men and women had an average SEBT-ANT score of, respectively, 65.1% and 67.7% of leg length. In 20 (15%) subjects, the first injured body site involved the ankle. Across all participants, a below average SEBT-ANT score was not associated with increased ankle injury odds (OR OR=2.43, 95% CI: 0.94 to 6.29, p=0.07). In men, a below average SEBT-ANT score indicated sevenfold increased odds for ankle injury (OR=7.06, 95% CI: 1.43 to 34.92, p=0.02). In women, this relationship was not significant (OR=0.72, 95% CI: 0.19 to 2.71, p=0.62). CONCLUSIONS Below average normalised SEBT-ANT scores were associated with sevenfold likelihood for ankle injuries in men. In contrast, no relationship was found for the SEBT-ANT score and ankle injuries in woman. These results may provide directions for the implementation of screening tools, as part of an injury prevention programme, to identify male PETE students with an increased likelihood for ankle injuries.
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Affiliation(s)
- Sander Bliekendaal
- Amsterdam University of Applied Sciences, Centre for Applied Research in Sports and Nutrition, Amsterdam, Netherlands
| | - Janine Stubbe
- Codarts University College for the Arts, Rotterdam, Zuid-Holland, The Netherlands
- Performing Artist and Athlete Research Lab (PEARL), Rotterdam, Netherlands
- Erasmus MC Medical University Center Rotterdam, Department General Practice, Rotterdam, Netherlands
- Rotterdam Arts and Science Lab (RASL), Rotterdam, Netherlands
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports & Department of Public and Occupational Health, Amsterdam Movement Science, VU University Medical Center, Amsterdam, North Holland, The Netherlands
- UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Capetown, Capetown, South-Africa
- School of Physical Education, Faculty of Physical Therapy & Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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COMPARISON of LOWER QUARTER Y-BALANCE TEST SCORES for FEMALE COLLEGIATE VOLLEYBALL PLAYERS BASED on COMPETITION LEVEL, POSITION, and STARTER STATUS. Int J Sports Phys Ther 2019; 14:415-423. [PMID: 31681500 DOI: 10.26603/ijspt20190415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background The Lower Quarter Y-Balance Test (YBT-LQ) is used by sports medicine professionals to measure an athlete's dynamic balance. The YBT-LQ is used by clinicians to track recovery during clinical rehabilitation, assess an athlete's readiness to return to sport after injury, and to identify athletes potentially at-risk for a time-loss injury. Normative data for the YBT-LQ are lacking for female collegiate volleyball (VB) players. The purpose of this study was to examine preseason YBT-LQ scores and their relationships to level of competition, starter status, player position, and prior lower quadrant (i.e., low back and lower extremities) injury history. Methods One-hundred thirty-four female collegiate VB players (mean age = 19.3 ± 1.1 years) representing athletes from three levels of competition (D II = 32, D III = 77, NAIA = 25) participated in this study. Athletes reported their prior injury history and performed the YBT-LQ testing protocol. Results NAIA and D III athletes demonstrated significantly greater reach measures on the YBT-LQ than D II athletes in several directions. Starters demonstrated significantly greater reach measures in five out of eight reach directions. Liberos/defensive specialists/setters demonstrated significantly greater posterolateral and composite reach measures bilaterally. There was no difference in reach measures based on prior history of lower quadrant (low back and lower extremities) injury. Conclusion This study provides normative data for YBT-LQ in female collegiate volleyball players. The data presented in this report may be used by coaches and rehabilitation professionals when evaluating dynamic balance in healthy volleyball players and by clinicians to compare an injured athlete's recovery to norms. Level of Evidence 3b.
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Dobija L, Reynaud V, Pereira B, Van Hille W, Descamps S, Bonnin A, Coudeyre E. Measurement properties of the Star Excursion Balance Test in patients with ACL deficiency. Phys Ther Sport 2019; 36:7-13. [DOI: 10.1016/j.ptsp.2018.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 11/05/2018] [Accepted: 12/18/2018] [Indexed: 12/23/2022]
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Brumitt J, Nelson K, Duey D, Jeppson M, Hammer L. Preseason Y Balance Test Scores are not Associated with Noncontact Time-Loss Lower Quadrant Injury in Male Collegiate Basketball Players. Sports (Basel) 2018; 7:sports7010004. [PMID: 30586865 PMCID: PMC6359330 DOI: 10.3390/sports7010004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 11/16/2022] Open
Abstract
The Y-Balance Test-Lower Quarter has shown promise as a screening tool for identifying athletes at risk of injury. Subsequent studies, utilizing heterogeneous populations or different operational definitions of injury, have presented equivocal findings. Therefore, studies evaluating the efficacy of the Y-Balance Test to discriminate injury risk in a homogeneous population is warranted. One-hundred sixty-nine male (mean age 19.9 ± 1.5 y) collegiate basketball players were recruited during 2 consecutive seasons (2016–2017/2017–2018). Athletes completed the Y-Balance testing protocol at the start of each preseason. Athletic trainers tracked noncontact time-loss lower quadrant injuries over the course of the season. Receiver operator characteristic curves failed to identify cutoff scores; therefore, previously reported cutoff scores were utilized when calculating relative risk. There was no association between preseason Y-Balance Test scores and noncontact time-loss lower back or lower extremity injury in a population of male collegiate basketball players. This study adds to a growing body of evidence that demonstrates no relationship between preseason Y-Balance Test scores and subsequent injury.
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Affiliation(s)
- Jason Brumitt
- George Fox University, 414 N. Meridian St, Newberg, OR 97132, USA.
| | - Kyle Nelson
- Concordia University, Portland, OR 97132, USA.
| | - Duane Duey
- Linfield College, McMinnville, OR 97132, USA.
| | - Matthew Jeppson
- George Fox University, 414 N. Meridian St, Newberg, OR 97132, USA.
| | - Luke Hammer
- George Fox University, 414 N. Meridian St, Newberg, OR 97132, USA.
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Ferrer-Peña R, Moreno-López M, Calvo-Lobo C, López-de-Uralde-Villanueva I, Fernández-Carnero J. Relationship of Dynamic Balance Impairment with Pain-Related and Psychosocial Measures in Primary Care Patients with Chronic Greater Trochanteric Pain Syndrome. PAIN MEDICINE 2018; 20:810-817. [DOI: 10.1093/pm/pny160] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Raúl Ferrer-Peña
- Department of Physiotherapy, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Escuela Internacional de Doctorado, Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Centro de Salud Entrevías, Gerencia de Atención Primaria, Fundación para la Investigación e Innovación Biomédica en Atención Primaria de la Comunidad de Madrid (FIIBAP), Servicio Madrileño de Salud, Madrid, Spain
| | - Mónica Moreno-López
- Department of Physiotherapy, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
| | - César Calvo-Lobo
- Nursing and Physical Therapy Department, Institute of Biomedicine (IBIOMED), Universidad de León, Ponferrada, León, Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Physiotherapy, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain
- Hospital La Paz Institute for Health Research, IdiPAz, Madrid, Spain
| | - Josué Fernández-Carnero
- Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, Spain
- Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
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Slater LV, Vriner M, Schuyten K, Zapalo P, Hart JM. Sex Differences in Y-Balance Performance in Elite Figure Skaters. J Strength Cond Res 2018; 34:1416-1421. [PMID: 29489718 DOI: 10.1519/jsc.0000000000002542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Slater, LV, Vriner, M, Schuyten, K, Zapalo, P, and Hart, JM. Sex differences in Y-balance performance in elite figure skaters. J Strength Cond Res 34(5): 1416-1421, 2020-Asymmetrical dynamic balance compared with normative populations have been associated with increased risk of injury in athletes; however, it is unclear if the current data are similar to balance performance in figure skaters. Therefore, the purpose of this study was to compare performance on the Y-balance test between sexes and disciplines in elite figure skaters. Thirty-two senior level figure skaters from 3 different disciplines (singles, dance, and pairs) completed the Y-balance test on the take-off and landing leg. Absolute differences between limbs (cm), normalized differences between limbs (% leg length), and composite scores (CSs; % leg length) were calculated for all skaters. A multivariate analysis of variance was used to identify differences in performance based on discipline and sex. Females had a greater absolute difference between limbs (mean difference = -3.62 cm) and a greater normalized difference between limbs on the posterolateral (PL) reach compared with males (mean difference = -4.26% leg length). Ice dancers had larger CSs on the take-off leg compared with pair skaters (mean difference = 6.42%). These results suggest that male and female figure skaters demonstrate differences in dynamic balance in the PL direction, with female skaters exhibiting decreased reach on the landing leg, which may suggest asymmetrical hip strength in female figure skaters and increase risk of lower extremity injury in the landing leg. Sport performance professionals should consider these sex differences when designing strength programs for elite figure skaters.
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Affiliation(s)
- Lindsay V Slater
- Neuromechanics of Impaired Locomotion Lab, Shirley Ryan AbilityLab, Chicago, Illinois
| | - Melissa Vriner
- Athlete High Performance Department, United States Figure Skating, Colorado Springs, Colorado
| | - Kristen Schuyten
- Sports Medicine and Physical Therapy, University of Michigan Health System, Ann Arbor, Michigan; and
| | - Peter Zapalo
- Athlete High Performance Department, United States Figure Skating, Colorado Springs, Colorado
| | - Joseph M Hart
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia
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Hébert-Losier K. Clinical Implications of Hand Position and Lower Limb Length Measurement Method on Y-Balance Test Scores and Interpretations. J Athl Train 2017; 52:910-917. [PMID: 28937801 PMCID: PMC5687235 DOI: 10.4085/1062-6050-52.8.02] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
CONTEXT The Lower Quarter Y-Balance Test (LQ-YBT) was developed to provide an effective and efficient screen for injury risk in sports. Earlier protocol recommendations for the LQ-YBT involved the athlete placing the hands on the hips and the clinician normalizing scores to lower limb length measured from the anterior-superior iliac spine to the lateral malleolus. The updated LQ-YBT protocol recommends the athlete's hands be free moving and the clinician measure lower limb length to the medial malleolus. OBJECTIVE To investigate the effect of hand position and lower limb length measurement method on LQ-YBT scores and their interpretation. DESIGN Cross-sectional study. SETTING National Sports Institute of Malaysia. PATIENTS OR OTHER PARTICIPANTS A total of 46 volunteers, consisting of 23 men (age = 25.7 ± 4.6 years, height = 1.70 ± 0.05 m, mass = 69.3 ± 9.2 kg) and 23 women (age = 23.5 ± 2.5 years, height = 1.59 ± 0.07 m, mass = 55.7 ± 10.6 kg). INTERVENTION(S) Participants performed the LQ-YBT with hands on hips and hands free to move on both lower limbs. MAIN OUTCOME MEASURE(S) In a single-legged stance, participants reached with the contralateral limb in each of the anterior, posteromedial, and posterolateral directions 3 times. Maximal reach distances in each direction were normalized to lower limb length measured from the anterior-superior iliac spine to the lateral and medial malleoli. Composite scores (average of the 3 normalized reach distances) and anterior-reach differences (in raw units) were extracted and used to identify participants at risk for injury (ie, anterior-reach difference ≥4 cm or composite score ≤94%). Data were analyzed using paired t tests, Fisher exact tests, and magnitude-based inferences (effect size [ES], ±90% confidence limits [CLs]). RESULTS Differences between hand positions in normalized anterior-reach distances were trivial (t91 = -2.075, P = .041; ES = 0.12, 90% CL = ±0.10). In contrast, reach distances were greater when the hands moved freely for the normalized posteromedial (t91 = -6.404, P < .001; ES = 0.42, 90% CL = ±0.11), posterolateral (t91 = -6.052, P < .001; ES = 0.58, 90% CL = ±0.16), and composite (t91 = -7.296, P < .001; ES = 0.47, 90% CL = ±0.11) scores. A similar proportion of the cohort was classified as at risk with the hands on the hips (35% [n = 16]) and the hands free to move (43% [n = 20]; P = .52). However, the participants classified as at risk with the hands on the hips were not all categorized as at risk with the hands free to move and vice versa. The lower limb length measurement method exerted trivial effects on LQ-YBT outcomes. CONCLUSIONS Hand position exerted nontrivial effects on LQ-YBT outcomes and interpretation, whereas the lower limb length measurement method had trivial effects.
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Affiliation(s)
- Kim Hébert-Losier
- Faculty of Health, Sport and Human Performance, Adams Centre for High Performance, University of Waikato, Mount Maunganui, Tauranga, New Zealand
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